As Social Marketing Director at Billian, Jennifer Dennard is responsible for the continuing development and implementation of the company's social media strategies for Billian's HealthDATA and Porter Research. She is a regular contributor to a number of healthcare blogs and currently manages social marketing channels for the Health IT Leadership Summit and Technology Association of Georgia’s Health Society. You can find her on Twitter @JennDennard.

I know several readers of this blog (if not dozens) don’t pay much attention to the world of consumer healthcare reviews. Some seem to think they are populated only by the disgruntled few, and don’t paint a fair picture of providers’ true abilities. Some are of the opinion that too few patients utilize physician review sites (positively or negatively), and don’t present a large enough sample size for reviews to be meaningful. But, like social networks, those that read them are often far greater than those that actively contribute to them, as a recent study by PricewaterhouseCoopers points out.

“Scoring Healthcare: Navigating customer experience ratings” points that though only 24 percent of those surveyed have left online reviews, 48 percent have read them. The report also points out that, “Among those who have read healthcare reviews, 68 percent said they have used the information to select a doctor, hospital and to a lesser extent, a health plan, pharmacy and drug or medical device.”

Say what you will about sites like Healthgrades, Yelp, Consumer Reports or Facebook, they are becoming powerful consumer engagement tools, and giving them short shrift will not win providers any points in the countdown to Stage 2 of Meaningful Use. (October 1 is just over 170 days away, in case you were wondering.)

It’s interesting to note in light of the PwC report that the new Patient Engagement Index from Axial Exchange bases 25 percent of a hospital’s score on its social engagement, which includes its ratings on consumer review sites.

What I’d like to know from providers is:

Are you starting to pay more attention to consumer reviews?

If so, how are they affecting your overall patient engagement strategy?

If not, why? What other baskets are you placing your patient engagement eggs in?

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We have a real challenge in healthcare that won’t be easy to solve. In fact, we may not solve this problem. The challenge is knowing the quality of care that’s being provided by a doctor. This matters for so many things. Ideally we could base reimbursement on the quality of the care as opposed to the volume of care. If we had a good measurement for quality of care, none of us would go to doctors who didn’t provide a high quality of care.

Think about how it currently works. If a doctor’s costs or outcomes compare unfavorably with their colleagues, most of us will say, ‘That doctor’s patients are sicker than other doctors’ patients.” In many cases, that very well could be the case. I remember a similar discussion in the clinic I worked at where one doctor was always given the really complex patients, but then they all wondered why he was always running behind.

The problem is that we don’t have any really good ways to know if someones costs and outcomes are off because they have sicker patients or because they aren’t very good doctors. Plus, this doesn’t even really take into account the long term implications of the care that’s provided by a doctor. Maybe the up front cost was more, but the long term cost to the healthcare system and patient might end up being much less.

Like I said, we may never solve these problems because they are incredibly complex. I know that many people would look to big data to help solve this challenge. Big Data can do great things, but far too often it’s the cop out answer to really addressing the challenge. This is especially true because then it usually leads to us not having the data available for us to really solve the problem.

Even most doctors can’t judge the quality of care that another doctor provides. If it’s a doctor from their specialty that they work with on a regular basis, then they likely have some idea. However, except in really complex patients (which most aren’t), the interaction between doctors is pretty minimal. This isn’t a knock on doctors. It’s just the reality that if a doctor doesn’t have much interaction with another doctor, what basis do they have to know the quality of care another doctor provides?

All of the various doctor ranking systems miss this completely. Most users of those systems mistakenly assume that the ranking or ratings on those sites somehow reflect the quality of the doctor. As discussed above, there’s no way for these sites to assess the quality of the doctor. Instead, these websites rank and rate based solely upon customer service and not quality of care. Customer service can be an important factor in selecting a doctor, but quality of care measures would be infinitely more valuable.

How then do we measure the quality of care provided? I haven’t even mentioned the complexities around consistency of care. Some of my blog posts are better than others. The care provided by a doctor to one patient might be great, and the next patient only good. Plus, this also doesn’t take into account the quality of the patient. What if the patient withholds information which prevents the doctor from providing really quality care? Should we hold doctors responsible for the poor care they provide because of the patient’s choices?

This is a really slippery slope to start, but I’ve heard people talking about it. I’m sure it makes doctors cringe to even think about it. I don’t expect my doctor to be perfect, but I think it is good for doctors to be accountable. That’s just a really hard thing to do.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I was cruising around LinkedIn and took a second to look at my LinkedIn profile. Turns out I still need to add a few things to my profile. It’s hard to keep up with stuff like that. However, what I found most intriguing was the somewhat recently added Skills section on LinkedIn profiles. I’ve known about them since the beginning, but I hadn’t really looked how skills were being described by other members of the community. In fact, I purposefully tried not to influence people’s recommendations of my skills. I wanted to see which skills they would identify. Here’s what the results are as of today:
I find the results quite intriguing and I’m happy to say that the people on LinkedIn did a pretty good job profiling and endorsing my skills. The top skills are: Healthcare Information Technology, SEO, Blogging, EMR, and Social Media. That’s a pretty fair representation of my top skills. I live, eat, sleep and breathe those things every day. I am sad that Entrepreneurship wasn’t on the list, but maybe that’s not a skill people think about. I’m surprised that compassionate and caring didn’t make the list either;-)

As I think about that skills profile and the post about Physician Ranking Websites I did on EMR and HIPAA, I wonder if it would be valuable to allow people to endorse physician’s skills. I wonder if any doctor has tried to do this on LinkedIn and what that would look like. I know for example I could endorse my wife’s OB/GYN for a number of things that she did really well.

I like the idea of endorsement rather than ranking or review. In many ways it’s a subtle difference, but it’s an important difference. Besides the fact that the endorsements are simple to do and so there’s a greater chance that you’ll get more people involved, it also avoids some of the flame wars that can occur with physician review sites. Plus, the idea of physician rankings assumes that one is better than another when the fact might be that both doctors are great.

I also love the idea of having someone’s profile linked to their endorsement. This is partially where it can break down in healthcare. Some people with cancer might not want to endorse their oncologist if they haven’t told people they know about their cancer. Not to mention the potential big brother issues.

However, this isn’t the case with many doctors. For example, I don’t know how many times people haven’t asked my wife and I for a recommendation of a pediatrician or primary care doctor. We of course tell them which ones we’ve liked and which ones we didn’t like so much and why. Now imagine you could do something similar across all of your friends and associates.

I’m sure there’s potential for gaming this system and there’s other unintended consequences to this as well. Although, it intrigued me how well my LinkedIn contacts were able to identify my skills. I wonder if something similar could be done with doctors. Maybe Doximity could do something like this, but only doctors would be able to endorse other doctor’s skills. Although, as I said in my article linked above, even many doctors don’t know how good other doctors are. Depends on how often and in what ways they interact with the other doctors.